Avaliação do teste de aglutinação com partículas de látex sensibilizadas com exoantígeno bruto de Paracoccidioides brasiliensis no sorodiagnóstico da Paracoccidioidomicose

Paracoccidioidomicose (PCM), uma micose sistêmica granulomatosa causada pelo fungo dimórfico Paracoccidioides brasiliensis, é endêmica na América do Sul. Conídios provavelmente agem como propágulos infectantes e são inalados para os pulmões, onde ocorre a transformação à forma leveduriforme patogênica. Duas principais formas clínicas são consideradas: a forma aguda ou subaguda (tipo juvenil) e a forma crônica (tipo adulto). O diagnóstico definitivo da PCM inclui a observação direta da levedura multibrotante característica em fluidos biológicos e secções teciduais ou isolamento do fungo de materiais clínicos. Na PCM, testes sorológicos, além de auxílio diagnóstico, têm a função de acompanhamento durante e pós-tratamento. Portanto, a técnica utilizada precisa aliar sensibilidade e especificidade, para que o valor preditivo seja máximo e reprodutível. O propósito deste estudo foi avaliar um teste de aglutinação com látex (LA) para detectar anticorpos anti-P.brasiliensis contra antígeno bruto do fungo. Cinqüenta e uma (51) amostras de soro de pacientes com PCM foram testadas. Positividade foi observada em 84,31% (43/51), cujos padrões de aglutinação variaram de 1+ a 4+. Reatividade dessas amostras foi verificada em títulos variando entre 1:2 e 1:64. Reatividade cruzada foi observada com outras doenças fúngicas (aspergilose e histoplasmose), e com doenças não fúngicas. Amostras de soro humano normal não foram reativas. A sensibilidade, especificidade e valores preditivos, positivo e negativo, produzidos pelo teste LA foram 84,31%, 81,05%, 70,49% e 90,59%, respectivamente. Em conclusão, estes resultados mostram que o teste LA é instrumento útil no sorodiagnóstico da PCM, além de vantagens como baixo custo e rápida execução, a despeito de outros testes, tais como ID e Western blotting.

Fator de necrose tumoral-α, interleucinas-8 e 10 em sangue de cordão umbilical como marcadores de infecção neonatal precoce na rotura prematura de membranas pré-termo

Pós-graduação em Pediatria - FMB

Confiabilidade e validade das declarações de óbitos por câncer de útero no município de Belém, Pará, Brasil

Belém, Pára, Brasil, apresenta taxas de mortalidade por câncer de colo uterino bastante elevadas, justificando-se a análise da confiabilidade e validade da causa básica do óbito declarada. Selecionou-se declarações de óbito de residentes de Belém, de 1998-1999, com causa básica de morte neoplasia do colo, corpo e porção não especificada do útero e aquelas que mencionavam essas neoplasias em qualquer linha do atestado, totalizando 188 declarações de óbito. Efetuou-se nova codificação para análise da confiabilidade, aferida pela concordância simples e pela estatística kappa. A causa básica do óbito, após revisão de prontuários médicos e/ou laudos histopatológicos, foi considerada como padrão-ouro para análise da validade de critério, através do valor preditivo positivo. Observou-se concordância simples de 94,0% e kappa de 0,87, sugerindo alta confiabilidade na codificação da causa básica câncer de útero no sistema oficial. Na análise da validade, confirmou-se 120 das 127 originais como colo de útero, três das quatro codificadas como corpo de útero e 18 das 48 classificadas como porção não especificada. Registrou-se aumento de 11,2 % nas neoplasias de colo uterino e redução de 62,5% nos óbitos de porção não especificada do útero.

Classificação de Mallampati em fonação para predição da dificuldade de intubação traqueal em obesos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Assessment of central venous catheter-associated infections using semi-quantitative or quantitative culture methods

Semiquantitative (Maki) and quantitative (Brun- Buisson) culture techniques were employed in the diagnosis of catheter-related bloodstream infections (CRBSI) in patients who have a short-term central venous catheter (inserted for 30 days). The diagnosis of CRBSI was based on the results of semiquantitative and quantitative culture of material from the removed catheters. Catheter tips (118) from 100 patients were evaluated by both methods. Semiquantitative analysis revealed 34 catheters (28.8%) colonized by ≥15 colonyforming units (cfu), while quantitative cultures (34 catheters, 28.8%) showed the growth of ≥103 cfu/mL. Bacteremia was confirmed in four patients by isolating microorganisms of identical species from both catheters and blood samples. Using the semiquantitative culture technique on short-term central venous catheter tips, we have shown that with a cut-off level of ≥15 cfu, the technique had 100.0% sensitivity, specificity of 68.4%, 25.0% positive predictive value (PPV) and 100.0% negative predictive value (NPV), efficiency of 71.4% and a prevalence of 9.5%. The quantitative method, with a cut-off limit of ≥103 cfu/mL, gave identical values: the sensitivity was 100.0%, specificity 68.4%, positive predictive value (PPV) 25.0%, negative predictive value (NPV) 100.0%, efficiency 71.4% and prevalence 9.5%. We concluded that the semiquantitative and quantitative culture methods, evaluated in parallel, for the first time in Brazil, have similar sensitivity and specificity. Keywords: central venous catheter; semi-quantitative culture; quantitative culture; catheter-related bacteremia.

Disfunção temporomandibular em adolescentes: confiabilidade e validade de um questionario para pesquisa populacional, caracterização epidemiológica de uma amostra e estudo de potenciais fatores de risco

Pós-graduação em Reabilitação Oral - FOAR

Avaliação da acurácia do teste imunoenzimático e de sua contribuição no seguimento de pacientes com paracoccidioidomicose em tratamento e no diagnóstico de doença reativada

Pós-graduação em Doenças Tropicais - FMB

Cephalometric evaluation of the predictability of bimaxillary surgical-orthodontic treatment outcomes in long face pattern patients: a retrospective study

OBJECTIVE: The aim of this study was to compare by means of McNamara as well as Legan and Burstone's cephalometric analyses, both manual and digitized (by Dentofacial Planner Plus and Dolphin Image software) prediction tracings to post-surgical results. METHODS: Pre and post-surgical teleradiographs (6 months) of 25 long face patients subjected to combined orthognathic surgery were selected. Manual and computerized prediction tracings of each patient were performed and cephalometrically compared to post-surgical outcomes. This protocol was repeated in order to evaluate the method error and statistical evaluation was conducted by means of analysis of variance and Tukey's test. RESULTS: A higher frequency of cephalometric variables, which were not statistically different from the actual post-surgical results for the manual method, was observed. It was followed by DFPlus and Dolphin software; in which similar cephalometric values for most variables were observed. CONCLUSION: It was concluded that the manual method seemed more reliable, although the predictability of the evaluated methods (computerized and manual) proved to be reasonably satisfactory and similar.

Pelvic differences between brachycephalic and mesaticephalic cats and indirect pelvimetry assessment

Pelvic measurements were carried out in cats with various cranial conformations to (1) determine pelvic morphometry, (2) compare any pelvic differences with cranial conformation and gender and (3) determine whether body biometrics can be used to predict pelvic measurements. Thirteen brachycephalic and 14 mesaticephalic female cats and 17 brachycephalic and nine mesaticephalic male cats were used. Body and external pelvic measurements, as well as pelvic radiographs, were performed. Brachycephalic females all had external pelvic and radiographic measurements that were significantly smaller than those of the mesaticephalic females, including smaller pelvic inlet and outlet areas and a smaller pelvic canal shape. Brachycephalic females had wider and flatter heads than do mesaticephalic females. Similarly, brachycephalic males all have radiographic pelvic measurements that are smaller than those of mesaticephalic males. Males had larger pelvis measurements than did their female counterparts for both cranial types, and indirect pelvimetry did not demonstrate good predictive value in determining the internal pelvic measurements. Thus, we conclude that pelvic differences exist between genders and between brachycephalic and mesaticephalic cats. Furthermore, body biometric measurements do not have good predictive value for determining internal pelvic measurements.

Efficacy of sperm motility after processing and incubation to predict pregnancy after intrauterine insemination in normospermic individuals

Background: Intrauterine insemination (IUI) is widely used to treat infertility, and its adequate indication is important to obtain good pregnancy rates. To assess which couples could benefit from IUI, this study aimed to evaluate whether sperm motility using a discontinuous gradient of different densities and incubation in CO2 in normospermic individuals is able to predict pregnancy.Methods: A total of 175 couples underwent 175 IUI cycles. The inclusion criteria for women were as follows: 35 years old or younger (age range: from 27 to 35 years) with normal fallopian tubes; endometriosis grades I-II; unexplained infertility; nonhyperandrogenic ovulatory dysfunction. Men with normal seminal parameters were also included. All patients underwent ovarian stimulation with clomiphene citrate and human hMG or r-FSH. When one or (at most) three follicles measuring 18 to 20 mm were observed, hCG (5000 UI) or r-hCG (250 mcg) was administered and IUI performed 36-40 h after hCG. Sperm processing was performed using a discontinuous concentration gradient. A 20 microliters aliquot was incubated for 24 h at 37 degrees C in 5% CO2 following a total progressive motility analysis. The Mann-Whitney and Chi-square tests, as well as a ROC curve were used to determine the cutoff value for motility.Results: Of the 175 couples, 52 (in 52 IUI cycles) achieved clinical pregnancies (CP rate per cycle: 29.7%). The analysis of age, duration and causes of infertility did not indicate any statistical significance between pregnancy and no pregnancy groups, similar to the results for total sperm count and morphology analyses, excluding progressive motility (p < 0.0001). The comparison of progressive motility after processing and 24 h after incubation between these two groups indicated that progressive motility 24 h after incubation was higher in the pregnancy group. The analysis of the progressive motility of the pregnancy group after processing and 24 h after incubation has not shown any motility difference at 24 h after incubation; additionally, in couples who did not obtain pregnancy, there was a statistically significant decrease in progressive motility 24 h after incubation (p < 0.0001). The ROC curve analysis generated a cutoff value of 56.5% for progressive motility at 24 h after incubation and this cutoff value produced 96.1% sensitivity, 92.7% specificity, 84.7% positive predictive value and 98.3% negative predictive value.Conclusions: We concluded that the sperm motility of normospermic individuals 24 h after incubation at 37 degrees C in 5% CO2, with a cutoff value of 56.5%, is predictive of IUI success.

Comparative evaluation of the DPP (R) CVL rapid test for canine serodiagnosis in area of visceral leishmaniasis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gene expression profiling in leiomyosarcomas and undifferentiated pleomorphic sarcomas: SRC as a new diagnostic marker

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Immunohistochemical and molecular analysis of caveolin-1 expression in canine mammary tumors

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo da toxicidade de diferentes doses do Diuron (3-(3,4 -dichlorophenyl)-1,1-dimethylurea) no epitélio da bexiga de ratos wistas machos por microscopia eletrônica de varredura

Diuron (3-(3,4-Dichlorophenyl)-1,1-dimethylurea) is a substituted urea herbicide widely used on agricultural crops such as soy, cotton and sugar cane. In a previous long-term study this herbicide exerted carcinogenic activity on the urinary bladder and renal pelvis mucosa of Wistar rats and breast of mice. Also, it was shown to be carcinogenic to the mice skin in a initiation-promotion assay. In 1997, the northamerican EPA evaluated Diuron as a “known/likely” carcinogen for humans (USEPA, 2004). In a previous study developed at this laboratory, male Wistar rats treated with Diuron 2500 ppm during 20 weeks presented increased indices of cell proliferation and incidences of simple urothelial hyperplasia (HS) in the urinary bladder. Under scanning electron microscopy (SEM) severe urothelial necrosis and hyperplasia were observed. However, in that study the urinary bladders of animals exposed to lower doses of Diuron were not examined under SEM. Therefore, the possible dose-response influence of Diuron on the urothelium under SEM is not known. The present study aimed to analyze under SEM the urinary bladder of male Wistar rats exposed to 125 ppm, 500 ppm and 2500 ppm doses of Diuron through diet during 20 weeks and to compare to the previous histological findings in the same material. Under SEM, 125 ppm and 2500 ppm groups presented significantly (p<0,05) increased incidences of simple hyperplasia, i.e., 7/10 and 8/10 respectively, compared to control group and the 500 ppm group The sensitivity of SEM was higher since it detected a 45% incidence of hyperplasiaswhile the histological analysis found only 27%. Considering SEM as the gold-standard, histology showed a 44% sensitivity, 86.4% specificity, a positive predictive value of 72,7% and negative predictive value of 65,5% and accuracy of 67,5%. Scanning Electron Microscopy...(Complete abstract click electronic access below)

Principais marcadores utilizados na avaliação da qualidade do sêmen de animais domésticos

Methods of semen cryopreservation allow changes in spermatic cells, such as damage in plasma and acrossomal membrane and modifications in mitochondrial function due to a disorder in the lipidic bilayer. For effective oocyte fertilization, spermatozoa require functional competent membranes, and intact organelles, acrosome and DNA. However, most laboratory methods used to evaluate semen quality are not highly correlated with fertilizing capacity. The discovery of a variety of fluorochromes and compounds conjugated to fluorescent probes has enabled an accurate assessment of the viability, integrity and function of spermatozoa. Among the most used probes that label the various compartments of the sperm cell there are the membrane impermeable fluorescent dyes to test the membrane integrity, as well as acylated dyes that pass the intact membrane. For the acrossomal integrity the most commonly used method is lectins labeled by a fluorescent probe. The acrosome reaction and spermatic capacitation is detected by the evaluation of membrane architecture and disorder of lipids in plasma membrane. Mitochondrial function can be determined using markers for their aerobic activity. The DNA status of spermatozoa has been determined using the metachromatic properties of Acridine Orange, and the DNA fragmentation can also be assessed by TUNEL assay. Finally, DNA condensation is analyzed using a single cell DNA gel electrophoresis assay that indicates DNA compactation. This monograph aims to compile the various tests used to detect damaged spermatozoa under cryopreservation methods, searching for improve the predictive value of semen analysis with the intention of a successful conception